Efficacy of regenerative therapy in aggressive periodontitis: a systematic review and meta-analysis of randomised controlled clinical trials.

OBJECTIVES: To analyse evidence regarding the efficacy of periodontal regenerative procedures in intrabony defects in patients treated for aggressive periodontitis (AgP). MATERIAL AND METHODS: A systematic search of the literature for randomised controlled clinical trials including patients treated for aggressive periodontitis that compared a group treated with regenerative therapy with another group treated with surgical debridement alone was conducted by two independent reviewers. RESULTS: Six studies were included in the meta-analysis of clinical and/or radiographic parameters at 6 and 12 months. Probing pocket depth was smaller at 6 months in patients treated with regenerative therapies compared with those treated with regular debridement (1.00 mm, p < 0.001, 95% CI (0.67, 1.34)). At 12 months this difference was more marked (0.41 mm, p = 0.12, 95% CI (- 0.10, 0.91)). The distance between the cemento-enamel junction and the alveolar crest at both 6 (1.36 mm, p < 0.001, 95% CI (1.03, 1.68)) and 12 months (0.90 mm, p = 0.01, 95% CI (0.24, 1.56)) was smaller in the group treated with regeneration. CONCLUSIONS: The use of biomaterials for regenerative therapy in AgP may be more effective than surgical debridement. Better outcomes were observed in terms of probing pocket depth and distance between the cemento-enamel junction and the alveolar crest at 6 months. Regeneration should be considered as a therapy to prevent tooth loss, although more studies with larger sample size and longer follow-up are needed. CLINICAL RELEVANCE: Periodontal regeneration is effective in the treatment of intrabony defects in patients with AgP, as it leads to better outcomes in clinical and radiographic parameters.

Tooth loss and alveolar bone crest loss during supportive periodontal therapy in patients with generalized aggressive periodontitis: retrospective study with follow-up of 8 to 15 years.

AIM: To determine the incidence of tooth loss in patients with generalized aggressive periodontitis (GAgP) during supportive periodontal therapy (SPT), identify tooth loss risk factors, and quantify alveolar crest height changes on periapical X-ray during follow-up. MATERIAL AND METHODS: This retrospective study included 25 GAgP patients with 656 teeth after periodontal treatment (baseline). Data were gathered on sociodemographic, periodontal, and radiological variables at baseline and at the end of follow-up. Linear regression models were used to assess the association of risk factors with tooth loss. RESULTS: Twenty-eight teeth were extracted during SPT. The mean tooth loss per patient was 1.12 ± 2.01 for all causes and 0.9 ± 2.0 for periodontal disease after a mean follow-up of 10.9 ± 2 years. Clinical variables were improved at the end of follow-up, with a mean reduction of -1 ± 0.8 mm in probing pocket depth (-0.7 to -1.3, 95% CI) and -0.6 ± 0.9 mm in clinical attachment loss (-0.9 to -0.2, 95% CI). Mean alveolar bone crest loss at the end of follow-up was 0.36 ± 0.56 mm (0.10-0.61, 95% CI). Smoking was associated with tooth loss (p = 0.052). CONCLUSIONS: Tooth loss rate was low in GAgP in a regular supportive care programme. Clinical variables improved, and bone loss was minimal over time. Smoking was associated with tooth loss.